Vasc Spec Int.  2019 Dec;35(4):237-240. 10.5758/vsi.2019.35.4.237.

Total Endovascular Therapy of Abdominal Aortic Aneurysm, Peripheral Artery Disease, and Chronic Mesenteric Ischemia: A Challenging Case

• Megalopoulos A
• Anastasiadou C
• Galanos-Demiris K
• Trellopoulos G
• Galanis S

• KMID: 2469224
• DOI: http://doi.org/10.5758/vsi.2019.35.4.237

Abstract

We presented a challenging case of a patient diagnosed with abdominal aortic aneurysm (AAA), peripheral artery disease, and chronic mesenteric ischemia (CMI). Herein, we describe the treatment in this high-risk patient diagnosed with CMI who also had critical limb ischemia and his AAA had rapidly expanded. First we performed angioplasty and celiac arterial stenting. Afterwards, we proceeded to perform balloon angioplasty of the iliac arteries and chimney endovascular aneurysm repair (Ch-EVAR) preserving the inferior mesenteric artery (IMA). The patient was discharged three days later and his IMA remained patent eighteen months post-operation. A thorough pre-operative assessment is essential in such challenging cases. Minimally invasive procedures like endovascular therapy and the chimney technique extend the prognoses in high-risk patients.

Keyword

Chimney technique; Inferior mesenteric artery; Endovascular aneurysm repair

MeSH Terms

Aneurysm
Angioplasty
Angioplasty, Balloon
Aortic Aneurysm, Abdominal*
Extremities
Humans
Iliac Artery
Ischemia
Mesenteric Artery, Inferior
Mesenteric Ischemia*
Peripheral Arterial Disease*
Prognosis
Stents